An intestinal transplant may be a life-saving treatment for children with intestinal failure who develop serious complications from total parenteral nutrition, or TPN.
TPN provides liquid nutrition intravenously, through a catheter or needle inserted into a vein in the arm, groin, neck or chest. Long-term TPN can result in complications such as bone disorders, central venous catheter infections and liver failure. Over time, TPN can also damage veins used to administer the nutrition via the catheter. After receiving an intestinal transplant, patients can be transitioned from TPN to an oral diet, thus improving their health and quality of life.
The UCSF Organ Transplant Program is one of the few in the country that performs pediatric intestinal transplants. We are also leaders in kidney and liver transplants for children, attracting patients from throughout the West Coast. Some children, such as those with both intestinal failure and irreversible liver failure, may require a combined intestinal transplant and liver transplant.
Our team of intestinal transplant experts includes a pediatric surgeon, a transplant surgeon, liver specialists, gastroenterologists, nurses and nurse practitioners, social workers, child life specialists, pharmacists and dietitians specially trained in caring for children.
If your child has been referred for an intestinal transplant, he or she will complete an evaluation process with our transplant team to be sure that intestinal transplant is an appropriate treatment. During the evaluation, your child's medical history will be recorded and he or she will complete a thorough medical examination. You and your child will also have consultations with our doctors, nurses, dietitians, child life specialist and social worker.
As part of the evaluation your child will have a variety of tests, which may include, but are not limited to:
Intestinal transplant is a complex procedure that requires the expertise of specialists trained in pediatric transplants. The surgery may take up to 12 hours and involves either an isolated intestinal transplant alone, a combined liver and intestine transplant, or a multi-visceral transplant. Depending on what caused your child's intestinal failure and his or her overall medical condition, your doctor will determine which type of transplant best meets your child's needs.
Care after an intestinal transplant differs slightly for each child, depending on the child's medical history, type of transplant and medical condition at the time of the transplant. The length of the hospital stay also varies from child to child, and can range from several weeks to several months.
Immediately after your child's transplant, he or she will be taken to the intensive care unit (ICU) for close monitoring. A breathing tube will be inserted to help your child breathe. In most cases the tube can be removed within 24 hours after surgery. Many monitoring lines will also be attached. These too will be removed as your child becomes more stable.
When your child's ready to leave the ICU, he or she will be cared for in UCSF Benioff Children's Hospital. During this time, your child will have frequent blood draws, biopsies of the transplanted intestine through ileostomy and radiologic testing. These tests will help determine the health of your child's transplanted intestine. Your child will also begin weaning from total parenteral nutrition (TPN) and slowly start feeding through a feeding tube with a liquid nutritional supplement. Over time, your child will start an oral diet.
Reviewed by health care specialists at UCSF Benioff Children's Hospital.
Intestinal Rehabilitation and Transplantation Program
400 Parnassus Ave., 2nd Floor
San Francisco, CA 94143
Phone: (877) 762-6935